What is Yacoup Surgery and Which Patients Is It Performed?
The aortic root connects to the heart in the left ventricle, the main pumping chamber of the heart, and contains the aortic valve. The aortic valve manages the flow of blood from the left ventricle to the aorta. Yacoup surgery is a surgical technique to correct problems with the aortic root and aortic valve. It is one of the aortic valve sparing surgery methods.
The main purpose of this technique is to reshape and support the aortic root without replacing the aortic valve.
Operation Process
- A sternotomy (opening of the sternum) is performed by making an incision along the breastbone or, as we do, by entering under the armpit between the ribs.
- The heart is connected to a heart-lung machine. This heart-lung machine takes over the functions of the heart and lungs. This allows surgical intervention to be performed after the heart has been stopped. Aortic valve surgery is not possible without being connected to a heart-lung machine.
- The aortic root is isolated and the enlarged or aneurysmised area is removed.
- The aortic valve is separated from the surrounding connective tissue and suspended for a while. The coronary vessel ostia are removed and suspended in a button style.
- The enlarged aortic root is replaced with a synthetic graft. This graft takes over the function of the aortic root.
- The aortic valve is inserted into the graft and the valve is re-fixed.
- An external ring is placed on the aortic annulus to prevent further enlargement of the root.
- The ostium of the coronary vessels is sutured onto the graft.
- After the procedures are completed and the patient is weaned from the heart-lung machine, the repair is checked by TEE.
Postoperative Recovery Process
- After the patient’s condition stabilises following intensive care, he remains in hospital for about a week.
- After discharge from hospital, the recovery period begins and continues for several weeks.
- During the recovery process at home, it is important that the patient rests, takes his/her medication regularly and is under the supervision of a doctor.
Advantages of Yacoup Surgery
- There is no need for mechanical or bioprosthetic valves, which improves the patient’s quality of life and reduces the risk of complications in the long term.
- Anticoagulant (blood thinner) medication is not required because this surgical technique does not use a mechanical valve.
- Unlike bioprosthetic valves, the risk of deterioration over time and the need for reoperation is reduced.
Which Patients Is Yacoup Surgery Performed?
- Patients with Aortic Root Aneurysm: Patients with enlargement or ballooning of the aortic root are at risk of aneurysm rupture.
- People with Genetic Connective Tissue Diseases: People with genetic connective tissue diseases such as Marfan syndrome, Loeys-Dietz syndrome or Ehlers-Danlos syndrome are at risk of aortic root enlargement.
- Aortic root enlargement with aortic valve insufficiency: With Yacoub surgery, both the aortic root is corrected and the aortic valve is protected to prevent backflow of blood.
- Patients with Aortic Root Dissection: Aortic dissection is the rupture of the aortic wall and the movement of blood between the layers of the aortic wall.
Yacoup surgery is an effective treatment for patients with aortic root dilatation or aneurysm in which the aortic valves are preserved. However, the aortic root width must be below certain values. In cases where the aortic root width exceeds certain values, another valve-sparing surgery is the David operation. More information about the David operation will be given later. It also allows the aortic root to be repaired by preserving the aortic valve, thus improving the patient’s quality of life. It is important for patients to have a detailed discussion with their surgeon before considering surgery and to receive detailed information about the risks and benefits of the operation.
